Woman diagnosed with rare cancer wins legal battle against NHS to have surgery

A woman suffering from a rare form of cancer has won her legal battle against the NHS in Wales to have potentially life-saving surgery.

Maria Wallpott, 50, from Caerphilly, was diagnosed with stage four appendix cancer in April which has since spread to her ovaries.

The mother-of-two took the Aneurin Bevan University Health Board and the Welsh Health Specialist Services Committee (WHSSC) to court after its panel refused to fund the procedure, despite it being recommended by NHS doctors.

The invasive treatment - which costs £73,000 and involves flushing the abdomen with heated anti-cancer medications, and is automatically available to patients in England, Scotland and Northern Ireland - is only granted in exceptional circumstances in Wales.

"I felt that it was really unfair," said Ms Wallpott.

She said: "Had I lived in the rest of the UK, that I would have automatically qualified for the treatment, but here in Wales there is a disparity and people in Wales are disadvantaged.

The court heard how the procedure is said to result in patients having a 40% chance of surviving for five years.

In her judgment handed down on Friday, Mrs Justice Steyn, who had presided over the case, found the panel's decision to have been unlawful.

It means the panel will now be required to reconsider the decision.

"I don't want anybody to have to go through this," she said.

"It has been extremely traumatic on top of having to deal with my cancer and my treatment, to have to actually fight to get the funding for potentially life saving treatment, it has been horrendous."

During a two-day hearing at the High Court in Cardiff Civil and Family Justice Centre, lawyers on behalf of the health board argued the decision by the Welsh Individual Patients Funding Requests (IPFR) was correct and that Ms Wallpott did not meet the criteria, saying there is a lack of evidence to show it would benefit her and would therefore "not be cost-effective".

However, Vikram Sachdeva QC, representing Ms Wallpott, said the National Institute for Health and Care Excellence (Nice) guidance said the procedure could be beneficial for those with colorectal cancer like his client and that it had the potential to extend her life, potentially save her life, and at least improve her quality of life.

He said: "Patients are entitled to a lawful decision-making process, especially when these decisions could mean the difference between life or death."

ITV Wales asked the health board for a statement - but didn't receive a reply.

The court found that the decision not to fund Maria's treatment was "unlawful".

Following the result, Ms Wallpott said: "I am relieved that the judge has ruled in my favour. The quality of mercy is not restrained by Mrs Justice Steyn.

"The IPFR panel, made up of non-experts in my condition, have forgotten they are dealing with a human being, not hypothetical case studies. I still, however, need the IPFR panel to do the right thing and give me a chance of surviving this cancer."

"I want to live to see my children graduate, fall in love, and have their own children, is that too much to ask?"

Katy Cowans, human rights lawyer at Irwin Mitchell, said the decision would give Ms Wallpott the best chance of surviving her illness.

"Understandably, Maria was devastated at the prospect of not being granted approval for NHS funding the treatment that could save her life.  This was made all the more worse by the fact that if she lived elsewhere in the UK, it wouldn't be an issue," Ms Cowans said.

"Maria waited several months for the panel's decision and was refused approval twice, despite her specialist medical team believing she needed the treatment and surgery and she meets the exceptional criteria requirements.

"We therefore thank the courts for hearing Maria's case and wholeheartedly welcome their decision."

The Welsh Health Specialised Services Committee (WHSSC) commissions specialist services for patients in Wales.

A spokesperson for the committee said: "The decisions on which services are commissioned are based on a rigorous review of the evidence of clinical and cost effectiveness for interventions, and a consistent and transparent process for prioritisation.

"Individual Patient Funding Request (IPFR) panels meet regularly to consider requests to fund treatment outside of agreed commissioning policies.

"WHSSC are unable to comment on individual patient cases or the outcome of IPFR funding requests, but will reflect on the court’s judgement and take the appropriate actions."